Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229, USA.
Department of Radiology, University of Cincinnati Medical Center, Cincinnati, USA.
Abdom Radiol (NY). 2019 Sep;44(9):3107-3114. doi: 10.1007/s00261-019-02123-y.
To define the relationship between compartmental abdominal fat stores, liver and pancreatic fat fractions, and type 2 diabetes mellitus (T2DM) in children with non-alcoholic fatty liver disease (NAFLD).
This was a retrospective study of patients with NAFLD who underwent abdominal MRI between August 2015 and July 2017. Using an axial multi-echo Dixon-based sequence, liver fat fraction (LFF) and pancreatic fat fraction (PFF) were measured. The fat image was used to quantify abdominal fat depots (thickness, cross-sectional area) at the L2 vertebral level. Multivariable models with stepwise selection were created for prediction of LFF, PFF, and T2DM status based upon variables of clinical interest.
86 patients (70% male, 25% Hispanic, 58% Caucasian, 11% African American) with a mean age of 14.2 ± 3.2 years were included. 19 (22%) patients were pre-diabetic or diabetic. Only ethnicity was a predictor of LFF (P = 0.0023) with Hispanic ethnicity associated with the highest LFF. Depending on the model, either total abdominal fat area (P = 0.0003) or patient weight (P = 0.008) were the only predictors of PFF. No patient variable predicted T2DM status.
In our population, there was an association between ethnicity and LFF, with the highest LFF in Hispanics. The presence or severity of hepatic steatosis could not be predicted based on patient size or the distribution of abdominal fat in our cohort. Neither LFF nor PFF were predictive of T2DM.
定义儿童非酒精性脂肪性肝病（NAFLD）患者腹部腔室性脂肪储存、肝脏和胰腺脂肪分数与 2 型糖尿病（T2DM）之间的关系。
这是一项回顾性研究，纳入了 2015 年 8 月至 2017 年 7 月间接受腹部 MRI 检查的 NAFLD 患者。采用轴向多回波 Dixon 序列测量肝脏脂肪分数（LFF）和胰腺脂肪分数（PFF）。脂肪图像用于在 L2 椎骨水平定量腹部脂肪沉积（厚度、横截面积）。基于感兴趣的临床变量，采用逐步选择法建立多变量模型，以预测 LFF、PFF 和 T2DM 状态。
共纳入 86 例患者（70%为男性，25%为西班牙裔，58%为白种人，11%为非裔美国人），平均年龄为 14.2±3.2 岁。19 例（22%）患者为糖尿病前期或糖尿病患者。只有种族是 LFF 的预测因素（P=0.0023），西班牙裔与最高的 LFF 相关。根据不同的模型，要么是总腹部脂肪面积（P=0.0003），要么是患者体重（P=0.008）是 PFF 的唯一预测因素。没有患者变量可以预测 T2DM 状态。
在我们的人群中，种族与 LFF 之间存在关联，西班牙裔的 LFF 最高。在我们的队列中，肝脏脂肪变性的存在或严重程度不能根据患者的体型或腹部脂肪的分布来预测。LFF 和 PFF 均不能预测 T2DM。
